8/14/2019 Bristol and South Gloucestershire Older Peoples Mental Health Liaison
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Bristol & South GloucestershireOlder Peoples Mental Health Liaison
8/14/2019 Bristol and South Gloucestershire Older Peoples Mental Health Liaison
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Bristol & South Gloucestershire
Older Peoples Mental Health Liaison
Bristol & South Gloucestershire
Older Peoples Mental Health Liaison
Typical district general hospital with 500
beds will admit 5000 older people per year3000 will suffer a mental disorder.
On average, older people will occupy 330
of 500 beds at any time and 220 of thesewill have a mental disorder.
Who Cares Wins. Improving the outcome for older people admitted to thegeneral hospital: Guidelines for the development of Liaison Mental Health
Services for older people. 2005
8/14/2019 Bristol and South Gloucestershire Older Peoples Mental Health Liaison
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Bristol & South Gloucestershire
Older Peoples Mental Health Liaison
This means that the acute hospital will
have at least four times as many olderpeople with mental disorder on its wardsas the older peoples mental healthservice has on theirs.
8/14/2019 Bristol and South Gloucestershire Older Peoples Mental Health Liaison
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Bristol & South Gloucestershire
Older Peoples Mental Health Liaison
Three disorders: depression, dementia
and delirium account for 80% of this
mental disorder.
In a 500 bed hospital:
96 patients will have depression 102 have dementia 66 have delirium
8/14/2019 Bristol and South Gloucestershire Older Peoples Mental Health Liaison
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Bristol & South Gloucestershire
Older Peoples Mental Health Liaison
Mental disorder in this population is an
independent predictor of poor outcome:
increased mortality greater length of stay
loss of independent function higher rates of institutionalisation
8/14/2019 Bristol and South Gloucestershire Older Peoples Mental Health Liaison
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Bristol & South Gloucestershire
Older Peoples Mental Health Liaison
What is needed?
improved recognition (50% unidentified) improved assessment
improved treatment and care management
improved partnerships between health careand social care
improved education and training of staff
8/14/2019 Bristol and South Gloucestershire Older Peoples Mental Health Liaison
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Bristol & South Gloucestershire
Older Peoples Mental Health Liaison
Widow, 80, lives alone
Mild dementia (not identified)
Chest infection
GP sends to hospital
hospital acquired confusion
Stays in for 3 months
Despondent
Reduced mobility, weight loss,unsafe to return home
Discharged to a care home
www.intercom.net/~terrypl/photographypage
8/14/2019 Bristol and South Gloucestershire Older Peoples Mental Health Liaison
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Bristol & South Gloucestershire
Older Peoples Mental Health Liaison
Widow, 80, lives alone
Mild dementia (not identified)
Chest infection
GP sends to hospital
hospital acquired confusion
Joint working with ward, liaison and
social work departments
Discharged home with home caresupport after 10 days
www.plunge.com
8/14/2019 Bristol and South Gloucestershire Older Peoples Mental Health Liaison
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Bristol & South Gloucestershire
Older Peoples Mental Health Liaison
What we do:
triaged by mental health liaison nurse discussed in team meeting with Consultant
reassurance, management and medication
collaboration with social work department on:
risks and needs
capacity to make decisions
mental health support on discharge (if needed)
8/14/2019 Bristol and South Gloucestershire Older Peoples Mental Health Liaison
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Bristol & South Gloucestershire
Older Peoples Mental Health Liaison
An ideal team would include:
nursing medical
occupational therapy
psychology physiotherapy
social work
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Bristol & South Gloucestershire
Older Peoples Mental Health LiaisonBenefits for the patient:
dignity
independence
reduced length of stay (by 3.6 DAYS in BRI)
early access to treatment and care:
anti-dementia drugs
medication management
support for carers
social care
8/14/2019 Bristol and South Gloucestershire Older Peoples Mental Health Liaison
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Bristol & South Gloucestershire
Older Peoples Mental Health LiaisonBenefits for the hospital:
increases bed availability
reduced length of stay, cost-effective
does not discriminate by age
basic care
liaison services
sense of mastery for staff
training, education, skills, job satisfaction
8/14/2019 Bristol and South Gloucestershire Older Peoples Mental Health Liaison
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Bristol & South Gloucestershire
Older Peoples Mental Health Liaison
You decide!